Hyperpituitarism (patient information): Difference between revisions
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'''For the WikiDoc page for this topic, click [[Hyperpituitarism|here]]''' | '''For the WikiDoc page for this topic, click [[Hyperpituitarism|here]]''' | ||
{{Infobox_Disease | |||
| Name = {{PAGENAME}} | |||
| Image = | |||
| Caption = | |||
| DiseasesDB = | |||
| ICD10 = {{ICD10|E|22||e|20}} | |||
| ICD9 = {{ICD9|253.1}} | |||
| ICDO = | |||
| OMIM = | |||
| MedlinePlus = | |||
| eMedicineSubj = | |||
| eMedicineTopic = | |||
| MeshID = D006964 | |||
}} | |||
{{SI}} | {{SI}} | ||
{{CMG}}; '''Associate Editor(s)-In-Chief:''' Jinhui Wu, M.D. | |||
==Overview== | |||
Hyperpituitarism is the disorder of excess secretion of adenohypophyseal trophic hormones, which is commonly caused by a functional [[pituitary adenoma]]. Usual symptoms depend on the cell types affected. Common clinical manifestations of hormone excess may include [[hyperprolactinaemia]], [[Cushing's disease]], [[precocious puberty]], [[gigantism]] or [[acromegaly]]. Usual signs and symptoms include [[headache]], excessive [[sweating]], [[hoarseness]], [[galactorrhea]], [[sleep apnea]], [[osteoporosis]] and [[hypertension]]. Hormone tests and cranial [[MRI]] may help disgnosis. Treatments of hyperpituitarism focus on [[surgery]] to remove the [[tumor]] and inhibition of synthesis or secretion of such abnormal hormones. | |||
==What are the symptoms of hyperpituitarism?== | |||
==What | |||
Signs and symptoms of hyperpituitarism are the excessive production of [[growth hormone]] and abnormal hormone excretion controlled by the [[pituitary]], such as [[prolactin]] and [[thyroid hormone]]s. | Signs and symptoms of hyperpituitarism are the excessive production of [[growth hormone]] and abnormal hormone excretion controlled by the [[pituitary]], such as [[prolactin]] and [[thyroid hormone]]s. | ||
*[[Gigantism]] in children. | |||
*Abnormal growth of hands and feet in adults | |||
*[[Headache]] | |||
*Visual field loss or [[double vision]] | |||
*Excessive [[sweating]] | |||
*[[Hoarseness]] | |||
*[[Galactorrhea]] | |||
*[[Sleep apnea]] | |||
*[[Carpal Tunnel syndrome]] | |||
*[[Joint pain]] and limitation of motion | |||
*[[Muscle weakness]] | |||
*[[Numbness]] or tingling of skin | |||
*[[Osteoporosis]], [[kyphosis]] | |||
*[[Hypertension]], [[arteriosclerosis]], even [[heart failure]] | |||
==Who is at highest risk?== | |||
*[[Pituitary tumor]] | |||
*[[Carcinoid tumor]]s | |||
== | ==Diagnosis== | ||
*Hormone tests: Hyperpituitarism are is the excessive production of [[growth hormone]] and abnormal hormone excretion controlled by the [[pituitary]], such as [[prolactin]] and [[thyroid hormone]]s. In patients with hyperpituitarism, it shows elevated [[growth hormone]] level, accompanying [[diabetes]], elevated IGF-1 factor (Insulin-like growth factor), elevated [[prolactin]] level, decreased free thyroxine level and elevated [[thyroid stimulating hormone]] (TSH). | |||
*[[Liver function]] and [[renal function]] tests: Patients with hyperpituitarism show elevated [[liver function]], elevated [[phosphorus]] and blood urea nitrogen ([[BUN]]) levels. | |||
*Cranial [[MRI]]: Since [[pituitary tumor]]s are the most common cause of this condition, it may show pituitary tumor signs in MRI. The MRI uses magnetic fields but which is a different imaging type from computed tomography (CT) to produce detailed images of the body. | |||
==When to seek urgent medical care?== | ==When to seek urgent medical care?== | ||
If you develop signs and symptoms associated with hyperpituitarism, see your doctor to determine the cause. If you experience either of the following symptoms, seeking urgent medical care as soon as possible: | |||
*[[Palpitation]] | |||
*[[Chest pain]] | |||
*Severe [[hypertension]] | |||
==Treatment options== | ==Treatment options== | ||
Treatment opinion depends on the cause and the cell types affected. | |||
*Treatments of [[pituitary tumor]]: Surgical removal of tumor is the first selection for the treatment. If failed, [[radiation therapy]], or [[gamma knife]] radiation treatment may be helpful. | |||
*Inhibiting [[growth hormone]] (GH) synthesis or secretion: Doctors often use [[bromocriptine]] to inhibit GH synthesis and use [[octreotide]] to suppress GH secretion in at least two-thirds of patients with [[acromegaly]]. | |||
*For [[Cushing disease]]: The main treatment for patients with Cushing disease is transsphenoidal microsurgery. The adjunctive drugs such as [[metyrapone]], [[aminoglutethimide]] and [[ketoconazole]] are used to inhibit the enzymes responsible for cortisol synthesis. | |||
*Treatments [[complication]]s such as [[hypertension]] and [[arteriosclerosis]]: Regular monitoring of [[blood pressure]] is important. Low-salt and low-fat diets, drugs such as [[ACE inhibitor]]s and [[angiotensin receptor blocker]]s (ARBs) may help control [[blood pressure]]. | |||
==Diseases with similar symptoms== | ==Diseases with similar symptoms== | ||
*[[Marfan Syndrome]] | |||
*[[Fragile X syndrome]] | |||
*[[Thymoma]] | |||
*[[Tuberous sclerosis]] | |||
*[[Wilms tumor]] | |||
*[[Multiple endocrine neoplasia]] | |||
==Where to find medical care for hyperpituitarism?== | ==Where to find medical care for hyperpituitarism?== | ||
| Line 46: | Line 72: | ||
==Prevention of hyperpituitarism== | ==Prevention of hyperpituitarism== | ||
The prevention of hyperpituitarism is unknown. | |||
==What to expect (Outook/Prognosis)?== | ==What to expect (Outook/Prognosis)?== | ||
Prognosis of hyperpituitariam depends on the hormone level affected. | |||
*Whether the patient has been treated with [[surgery]] to remove the [[tumor]]. | |||
*For [[hyperprolactinemia]]: The undetectable level (<2 µg/L) of [[prolactin]] predicts cure with more than 90% probability. On the contrary, higher values within the reference range indicate incomplete removal of the adenoma. | |||
*Postoperative serum GH levels: Basal serum GH levels obtained immediately after [[surgery]] suggest the outcome of tumor recurrence in children with GH-releasing adenomas. The higher the GH levels are, the worse of the prognosis will be. | |||
*For hyperpituitariam resulting from [[corticotropinoma]]: The concentration of plasma [[cortisol]] concentration in the morning and corticotropin concentration over 24 consecutive hours measured 4-7 days after surgery may demonstrate the prognosis. The lower the concentrations are, the better outcomes will be. | |||
{{WH}} | |||
{{WS}} | |||
[[Category:Medicine]] | |||
[[Category:Endocrinology]] | |||
[[Category:Patient information]] | |||
[[Category:Endocrinology patient information]] | |||
[[Category:Disease]] | |||
[[Category:Mature chapter]] | |||
[[Category: | |||
Latest revision as of 20:10, 21 January 2012
For the WikiDoc page for this topic, click here
| Hyperpituitarism (patient information) | |
| ICD-10 | E22 |
|---|---|
| ICD-9 | 253.1 |
| MeSH | D006964 |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Jinhui Wu, M.D.
Overview
Hyperpituitarism is the disorder of excess secretion of adenohypophyseal trophic hormones, which is commonly caused by a functional pituitary adenoma. Usual symptoms depend on the cell types affected. Common clinical manifestations of hormone excess may include hyperprolactinaemia, Cushing's disease, precocious puberty, gigantism or acromegaly. Usual signs and symptoms include headache, excessive sweating, hoarseness, galactorrhea, sleep apnea, osteoporosis and hypertension. Hormone tests and cranial MRI may help disgnosis. Treatments of hyperpituitarism focus on surgery to remove the tumor and inhibition of synthesis or secretion of such abnormal hormones.
What are the symptoms of hyperpituitarism?
Signs and symptoms of hyperpituitarism are the excessive production of growth hormone and abnormal hormone excretion controlled by the pituitary, such as prolactin and thyroid hormones.
- Gigantism in children.
- Abnormal growth of hands and feet in adults
- Headache
- Visual field loss or double vision
- Excessive sweating
- Hoarseness
- Galactorrhea
- Sleep apnea
- Carpal Tunnel syndrome
- Joint pain and limitation of motion
- Muscle weakness
- Numbness or tingling of skin
- Osteoporosis, kyphosis
- Hypertension, arteriosclerosis, even heart failure
Who is at highest risk?
Diagnosis
- Hormone tests: Hyperpituitarism are is the excessive production of growth hormone and abnormal hormone excretion controlled by the pituitary, such as prolactin and thyroid hormones. In patients with hyperpituitarism, it shows elevated growth hormone level, accompanying diabetes, elevated IGF-1 factor (Insulin-like growth factor), elevated prolactin level, decreased free thyroxine level and elevated thyroid stimulating hormone (TSH).
- Liver function and renal function tests: Patients with hyperpituitarism show elevated liver function, elevated phosphorus and blood urea nitrogen (BUN) levels.
- Cranial MRI: Since pituitary tumors are the most common cause of this condition, it may show pituitary tumor signs in MRI. The MRI uses magnetic fields but which is a different imaging type from computed tomography (CT) to produce detailed images of the body.
When to seek urgent medical care?
If you develop signs and symptoms associated with hyperpituitarism, see your doctor to determine the cause. If you experience either of the following symptoms, seeking urgent medical care as soon as possible:
- Palpitation
- Chest pain
- Severe hypertension
Treatment options
Treatment opinion depends on the cause and the cell types affected.
- Treatments of pituitary tumor: Surgical removal of tumor is the first selection for the treatment. If failed, radiation therapy, or gamma knife radiation treatment may be helpful.
- Inhibiting growth hormone (GH) synthesis or secretion: Doctors often use bromocriptine to inhibit GH synthesis and use octreotide to suppress GH secretion in at least two-thirds of patients with acromegaly.
- For Cushing disease: The main treatment for patients with Cushing disease is transsphenoidal microsurgery. The adjunctive drugs such as metyrapone, aminoglutethimide and ketoconazole are used to inhibit the enzymes responsible for cortisol synthesis.
- Treatments complications such as hypertension and arteriosclerosis: Regular monitoring of blood pressure is important. Low-salt and low-fat diets, drugs such as ACE inhibitors and angiotensin receptor blockers (ARBs) may help control blood pressure.
Diseases with similar symptoms
- Marfan Syndrome
- Fragile X syndrome
- Thymoma
- Tuberous sclerosis
- Wilms tumor
- Multiple endocrine neoplasia
Where to find medical care for hyperpituitarism?
Directions to Hospitals Treating hyperpituitarism
Prevention of hyperpituitarism
The prevention of hyperpituitarism is unknown.
What to expect (Outook/Prognosis)?
Prognosis of hyperpituitariam depends on the hormone level affected.
- Whether the patient has been treated with surgery to remove the tumor.
- For hyperprolactinemia: The undetectable level (<2 µg/L) of prolactin predicts cure with more than 90% probability. On the contrary, higher values within the reference range indicate incomplete removal of the adenoma.
- Postoperative serum GH levels: Basal serum GH levels obtained immediately after surgery suggest the outcome of tumor recurrence in children with GH-releasing adenomas. The higher the GH levels are, the worse of the prognosis will be.
- For hyperpituitariam resulting from corticotropinoma: The concentration of plasma cortisol concentration in the morning and corticotropin concentration over 24 consecutive hours measured 4-7 days after surgery may demonstrate the prognosis. The lower the concentrations are, the better outcomes will be.